With You through COVID-19: crisis and recovery
We worked fast to shift to remote delivery, but this has its limits. What could be a new normal for services based on relationships?
Everyone will remember these first few months of 2020. As coronavirus swept across the world, our lives changed. We contended with new fears, learnt new behaviours and norms, and adapted to new guidance and regulations that will shape our experiences for many years to come. This shared trauma — our response to a distressing or disturbing event — will have a lasting impact.
No, the virus has not been a great leveller. As it spread, it exposed the cracks and widened gaps in our society and economy that have been with us for a long time. For people already on the brink of crisis, perhaps in precarious work, living on a low income or struggling with ill-health, any new risk may be overwhelming. Without a safe or stable home, whether due to a lack of adequate physical space or the relationships within it, lockdown brings daily threat. Isolation is a very different prospect if it comes on top of existing mental health problems, loneliness, or the challenge of maintaining recovery from previous harms.
“For families that are already vulnerable, the issues that they may have been able to cope with before have intensified and got harder — relationships, domestic abuse and cuckooing for example” — frontline staff member
“Not all of the young people we work with live in the best of home environments, and school would have been the safest place for them. Many of those that could have stayed in school aren’t attending.” — frontline staff member
We can’t possibly know all of the different, complicated and unfair ways that the virus is affecting us. As a service that cares for people in difficult situations, I am humbled and amazed on a daily basis by the creative and determined ways our frontline staff are trying to stay in touch with people. We were fortunate in having some strong digital foundations, so were able to shift quickly into remote working — moving groups and 121s online, scaling support through web chat and online advice, helping people stay connected and part of communities from home — and make sure people can get clean equipment and essential medication with social distancing guidance in place.
Everyone is working very hard.
But we can also see the limits of what we can do, and the beginnings of a second wave crisis as the long-tail effects of anxiety, grief and insecurity take hold.
“In general I think people’s mental health has worsened during the crisis” — frontline staff member
The crisis as a catalyst for change
It’s long been clear that the way public services are designed and delivered can be at odds with our very human and universal desire for relationships, connection and agency. The standard components of many health, care and welfare services — assessments, forms, care plans, caseloads — can make sure we prioritise needs and respond safely, but can too easily overtake and obscure what will really support change. Systems that prioritise ticks in boxes don’t fit with complex situations, and staff time is too often absorbed with battling bad technology and administering processes rather than working with people on their own terms.
In response to coronavirus, we’ve seen that a different future is possible. Schools very quickly cancelled exams, and gave teachers the scope to design lessons and materials in whatever way will help children engage productively. GPs have dropped all waiting lists and introduced remote consultations, which many are finding a useful way to connect with patients for non-urgent care. Government has introduced new, universal welfare in the Job Retention Scheme, designing and launching a completely new system in a matter of weeks. Change and innovation often follows periods of crisis like this, as we start to rebuild. Some changes we will want to leave behind us, but what should we take forward?*
At With You, we’ve started to explore some principles for how we might redesign recovery in future, not as a blueprint for delivery but as a shared direction for change. Although we are still adjusting and learning what works — both for staff and people we support — some principles are emerging.
Beyond buildings
For many public services, physical buildings are the anchor of delivery.** Whether large, hub facilities or local community centres, so much of our contact with services is visiting a physical location in person during 9am-5pm office hours. Since lockdown, many of us are craving this kind of physical interaction — the chance to convene in a real world space — and there’s no question that in person, face to face contact is the foundation for any relational service.
But just as there is a digital divide, buildings can be a barrier — especially for rural areas or anyone navigating caring, work or financial demands.
We know that showing up to ask for help is hugely daunting; as we start to think about reopening buildings, how can we take more of our support beyond four walls? How could we shift the dynamic of ‘client’ and ‘professional’ by coming together in new spaces, both on and offline? Many of our services are exploring more outreach and community based support, and how we might take walks with individual clients at safe distances outside. In Cornwall, street outreach teams are making sure we’re staying connected to people who are homeless, joining up with local networks and brokering access to the right help. What sort of infrastructure will we need in future?
Embracing diversity and flexibility
Human beings are universally complicated, different and demanding. Some of us like structure to our days, and thrive with routine. Others may want more variety. Though we may face common issues, how we experience things and our goals and priorities for change are our own. People experiencing problems with drugs, alcohol and mental health are no different.
Coronavirus has forced us to work with people in different ways: how we communicate; how we triage and flex treatment programmes to fit around changed routines; how we provide access to medications and supervise consumption; what we need to do as professionals and what groups or individuals can do themselves. It’s also meant staff working more flexibly, faced with organising our days around childcare, home-schooling and other responsibilities. We know that flexibility can make support more accessible and can also introduce new barriers, for example through our work with older adults and alcohol. How should we structure how we work so it is more inclusive for everyone? What should we take forward longer-term?
Parity with peers and recovery communities
The start of lockdown brought with it a groundswell of community action. Volunteer groups, local networks and communities pulled together to make sure people felt connected and had what they needed. As a service we’ve seen this resourcefulness and commitment in the many hundreds of volunteers and recovery champions working hard to make sure that no one is without support. We provide a platform to support and facilitate peer to peer connection and recovery, creating the space for people to come together. What would it mean to amplify and invest more in these communities? How could this change our role?
In Glasgow, we support large recovery communities in the North East and West of the city. In the first few weeks of the crisis, volunteers cooked meals and delivered parcels of essential items to hundreds of homes. The team have encouraged anyone to suggest and lead online groups and activities, and they are now supporting a thriving online network with various exercise groups, quizzes and emotional support. Although tough for everyone, the situation has brought the community closer together.
Rising to the challenge
“We are consistently impressing on our service users the need to change. Well, now I feel it’s up to us to lead by example” — Team Leader, With You in North Somerset
As well as the inspiring work within our services, it’s been brilliant to see the collaboration between charities and public services in response to coronavirus. I’ve valued being part of groups facing common challenges and sharing ideas. I hope we can bring this same commitment and shared purpose to building a vision for change over the longer term, not just in our own organisations but shaping standards and expectations across whole systems and working collaboratively to meet them.
Digital and technology have been fundamental to our response to coronavirus. I’m glad that we’ve invested in the capabilities in house to be able to quickly adapt and respond as things change. Looking ahead, there are new drivers for transformation, beyond digital channels and remote delivery, to create the building blocks and infrastructure that will support more flexible, inclusive and relational ways of working.
The long tail of this crisis will be felt for decades. For people already facing issues with addiction and mental health, these may intensify. More people will find themselves in a hard place, looking for a way out. As a sector, we need to be ready and rise to meet this challenge so that we continue to be there for anyone who needs support.
As we start to learn to live with coronavirus, what does recovery look like? How can we support positive change, and lead by example?
- Thanks to Matthew Taylor and Ian Burbidge at the RSA for their post ‘The Path from Crisis” and framework for understanding crisis response measures. We’ve used this to help structure some of our thinking. https://medium.com/bridges-to-the-future/the-path-from-crisis-6d3f83c96d0b
- ** Reference here to Dr Sarah Schulman and the team’s work at InWithForward in Canada https://inwithforward.com/
These are tough times for everyone. Our services are open and we’re here to work alongside you during this difficult time. Visit our website for information and advice, to chat to a trained advisor or to find your local service.
